Public Policy That Makes Test Subjects of Us All

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Suppose you wanted to test the effects of halving the amount of salt in people’s diets. If you were an academic researcher, you’d have to persuade your institutional review board that you had considered the risks and obtained informed consent from the participants.

But if you are the mayor of New York, no such constraints apply. You can simply announce, as Michael Bloomberg did, that the city is starting a “nationwide initiative” to pressure the food industry and restaurant chains to cut salt intake by half over the next decade. Why bother with consent forms when you can automatically enroll everyone in the experiment?

And why bother with a control group when you already know the experiment’s outcome? The city’s health commissioner, Thomas R. Frieden, has enumerated the results. If the food industry follows the city’s wishes, the health department’s Web site announces, “that action will lower health care costs and prevent 150,000 premature deaths every year.” [snip]

After reviewing the literature for the Cochrane Collaboration in 2003, researchers from Copenhagen University concluded that “there is little evidence for long-term benefit from reducing salt intake.”

A similar conclusion was reached in 2006 by Norman K. Hollenberg of Harvard Medical School. While it might make sense for some individuals to change their diets, he wrote, “the available evidence shows that the influence of salt intake is too inconsistent and generally too small to mandate policy decisions at the community level.”

In the past year, researchers led by Salvatore Paterna of the University of Palermo have reported one of the most rigorous experiments so far: a randomized clinical trial of heart patients who were put on different diets. Those on a low-sodium diet were more likely to be rehospitalized and to die, results that prompted the researchers to ask, “Is sodium an old enemy or a new friend?” [snip]

At the time, it seemed extraordinary for a city to be forbidding its diners to order a legal food product, particularly given the scientific uncertainties about trans fats and the possible harms resulting from the ban (see TierneyLab at nytimes.com/tierneylab).

But that local restaurant policy now seems fairly modest by comparison with Mr. Bloomberg’s and Dr. Frieden’s plans for salt. Soon, wherever you live, wherever you eat, you could be part of their experiment.

[I.e., arrogance run amok - a.k.a. 'government'. And the nanny state is accelerating... ]

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